【肠道吸收不良、乳糜泻及相关淋巴瘤:从症状到诊断】。

G Gasbarrini, G R Corazza, F Biagi, G Brusco, M L Andreani, S Malservisi, A V Greco
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引用次数: 0

摘要

肠道吸收不良的临床后果是非常多变的,吸收不良、吸收不良综合征和肠病之间的分离经常被注意到。肠病并不总是导致吸收不良和吸收功能试验的改变。以下与临床实践特别相关:乳糜泻、微生物制剂引起的吸收不良(包括惠普尔病)、术后吸收不良和选择性碳水化合物吸收不良。特别是,乳糜泻已经从各个方面进行了分析,从器官培养研究到免疫学假设,从经典品种到亚临床形式以及严重并发症,如肠病相关T细胞淋巴瘤。吸收不良综合征的诊断严重不足:在典型的乳糜泻病例中,肠病是临床冰山,而以多形态亚临床品种为代表的淹没部分的发现才刚刚开始。就肠道吸收不良而言,临床主要问题在于诊断。
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[Intestinal malabsorption, celiac disease and associated lymphoma: from symptoms to diagnosis].

The clinical consequences of intestinal malabsorption are extremely variable and a dissociation between malabsorption, malabsorption syndrome and enteropathy is often noted. Enteropathy does not always results in malabsorption and in an alteration of the tests exploring the absorptive function. The following have particular relevance in clinical practice: coeliac disease, malabsorption induced by microbiologic agent (including Whipple's disease), post-surgical malabsorption and selective carbohydrate malabsorption. In particular, coeliac disease has been analyzed in its various aspects, from studies with organ cultures to immunological hypotheses, from the classical variety to subclinical forms and to serious complications, such as enteropathy-associated T cell lymphoma. Malabsorption syndromes are dramatically underdiagnosed: in the typical case of coeliac disease, enteropathy represents a clinical iceberg, and the discovery of the submerged portion, represented by the polymorphous subclinical varieties, has just started. As far as intestinal malabsorption is concerned, the main clinical problem regards diagnosis.

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